Astragalus has been used in traditional Chinese medicine (TCM) with other herbs to stimulate the immune system. It is also used in combination with chemotherapy to reduce adverse effects. Based on traditional use and clinical experience, astragalus is generally considered to be safe.

Early research suggests potential uses for astragalus when combined with other herbs. It is unclear if astragalus alone will have the same effects. Well-designed clinical trials evaluating astragalus on its own are needed before a conclusion can be drawn.

Astragalus is a large genus of over 2,000 species. Gummy sap (called tragacanth) from astragalus is used as a thickener in ice cream, as a denture adhesive, and as an antidiarrheal agent.

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

GRADE *

Early research reports that astragalus, as part of a combination formula, decreased runny nose from allergies. More well-designed trials are needed.

C

A combination of herbs including astragalus showed benefit in treating anorexia. Research using astragalus alone is needed before a conclusion can be drawn.

C

Early research reports that astragalus, as part of an herbal combination formula, may have beneficial effects in aplastic anemia. Studies are needed on astragalus alone before a conclusion may be made.

C

Limited evidence suggests that astragalus, in addition to a strong red light and an electromagnetic field (EMF) neutralizer, may have beneficial effects on severe asthma. Additional studies on astragalus alone are needed on this topic.

C

According to early research, an astragalus-containing combination formula may reduce fatigue and increase athletic performance. Further research is needed before a conclusion can be drawn.

C

Limited evidence suggests that an astragalus combination product may be more effective than Ritalin® in reducing attention-deficit disorder symptoms. However, astragalus may not exhibit greater efficacy than Ritalin®. Well-designed trials examining astragalus alone are needed.

C

Limited research suggests that an astragalus-containing mixture may be an effective treatment for beta-thalassemia. Furthermore, astragalus may increase hemoglobin levels. Further study is needed in this area.

C

Few clinical trials have investigated the effects of astragalus among burn patients. Limited research suggests that astragalus may positively affect levels of various blood endpoints. Further research is required before strong conclusions may be made.

C

Limited evidence suggests that astragalus may be beneficial for children with cerebral palsy. Further research is needed before a conclusion can be made.

C

Early research reports that an astragalus herbal mixture may improve quality of life in people undergoing chemotherapy. Additional well-designed research is needed before a conclusion can be made.

C

Limited evidence suggests that a combination including astragalus may decrease fatigue-related symptoms. Additional well-designed trials examining astragalus alone are needed in this area.

C

Limited evidence suggests that astragalus, as part of a combination therapy, may improve cognitive function. More research is required in this field before a conclusion can be drawn.

C

Astragalus is often used in Traditional Chinese Medicine as a part of herbal mixtures for upper respiratory tract infections. Antiviral activity has been reported in some studies. However, due to a lack of well-designed research, no firm conclusions may be drawn.

C

There is some evidence that astragalus may improve the effectiveness of conventional diabetes therapies and lower blood sugar. More research is required before a conclusion can be drawn.

C

There is some evidence that astragalus, as part of a combination therapy, may be an effective treatment for diabetic foot ulcers. More well-designed trials of astragalus alone are needed before a conclusion can be drawn.

C

Limited research reports that astragalus extract may improve cancer-related fatigue. Additional research is needed in this area.

C

Astragalus may improve hearing in people with hearing loss. Further well designed study is needed.

C

Astragalus may benefit heart disease through antioxidant properties. Research suggests astragalus may also improve the immune response and symptoms of heart failure. More well-designed trials are needed in this area.

C

Limited evidence suggests that astragalus, as part of a combination formula, may be effective in reducing H. pylori infections. More well-designed trials of astragalus alone are needed before a conclusion can be drawn.

C

Research suggests that astragalus may have antiviral effects and trigger an immune response against the viruses that cause hepatitis B and hepatitis C. Additional studies are needed in this area.

C

Research suggests that astragalus may have antiviral effects and trigger an immune response against herpes viruses. Additional studies are needed in this area.

C

Research suggests that astragalus may have antiviral effects and trigger an immune response against viruses. Astragalus in combination with other herbs in HIV patients may improve quality of life and HIV symptoms. Additional studies are needed in this area.

C

Several small studies report that astragalus may stimulate and improve immune system function. Further research is needed in this area.

C

Early research studying the effect of astragalus on infections is conflicting. Further research is required before a conclusion can be drawn.

C

Early research suggests that astragalus may be effective for kidney disease. However, there is insufficient evidence from human studies to support this claim.

C

In children with congenital heart disease, injection of astragalus protected against kidney injury. Further study is needed in this area.

C

Research suggests that astragalus may be effective against liver disease. Further research is required before a conclusion can be made.

C

Astragalus has been shown to improve immune parameters in patients with lupus. More studies are needed before a conclusion can be drawn.

C

There is unclear evidence for astragalus for reducing menopausal symptoms. Further research is required before a conclusion may be made.

C

Limited evidence suggests that astragalus, as part of a combination formula, may be beneficial in menstrual disorders. More well-designed trials of astragalus alone are needed.

C

Some evidence suggests that astragalus may aid the mental performance of children with low IQ. Further well-designed trials are required in this area.

C

Limited evidence suggests that astragalus, as part of a combination formula, may benefit immune function in people with myasthenia gravis. More well-designed trials of astragalus alone are needed in this area.

C

Limited evidence suggests that astragalus, as part of a combination therapy, may relieve pain in people with chronic neck pain. More research is required before a conclusion can be drawn.

C

Limited evidence suggests that astragalus, as part of a combination formula, may benefit chronic prostate inflammation. More studies on astragalus alone are needed before a conclusion can be drawn.

C

Astragalus has been used traditionally to aid in smoking cessation. Well-designed studies are required before conclusions can be made.

C

Limited evidence suggests that astragalus, as part of a combination formula, may be effective in treating stroke. More well-designed trials of astragalus alone are needed before a conclusion can be drawn.

C

Limited evidence suggests that astragalus may benefit people with tuberculosis. Further well-designed studies are required before conclusions can be made.

C

Several studies suggest that astragalus may improve symptoms of heart inflammation. Astragalus may strengthen the immune response in response to viruses. However, larger, higher-quality studies are needed in this area.

C

Limited evidence suggests that astragalus, as part of a combination formula, may be useful for weight loss. More studies of astragalus alone are needed before a conclusion can be drawn.

C

* Key to grades

A: Strong scientific evidence for this useB: Good scientific evidence for this useC: Unclear scientific evidence for this useD: Fair scientific evidence for this use (it may not work)F: Strong scientific evidence against this use (it likley does not work)

Tradition / Theory
The below uses are based on tradition, scientific theories, or limited research. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. There may be other proposed uses that are not listed below.

General: In Chinese medicine, astragalus is used in soups, teas, extracts, and pills. In practice and in most scientific studies, astragalus is one component of multiherb mixtures. Therefore, the precise dosing of astragalus alone is not clear. A few studies have used astragalus extract or isolated astragaloside fractions. Astragalus is commercially available as a solid powdered extract, dried root, decoction, fluid extract, and tincture. The maximum level of astragalus used is 1.3% when given topically in lotions, denture creams, toothpastes, or cosmetics.

For allergies, an herb and mineral complex containing 80 milligrams of astragalus root per capsule has been taken by mouth.

For aplastic anemia (damaged bone marrow), 80-120 grams of astragalus has been injected into the blood once daily for 15 days.

For cancer, 60 milliliters of astragalus injection (equivalent to 120 grams of astragalus) in 250 milliliters of 5% dextrose has been injected into the blood once daily until termination of chemotherapy.

In addition to chemotherapy, 90 grams of astragalus has been taken by mouth daily as an oral tincture for 30 days. 20 milliliters of astragalus in 250 milliliters of saline has been injected in the blood once daily for three months or for 21 days during all four courses of chemotherapy treatment. An astragalus drip of 60 milliliters daily for 2-3 treatment cycles (each cycle lasting 21-28 days) in combination with chemotherapy has been injected in the blood. Additionally, 4 milliliters of Injectio Radici Astragali has been injected into the muscle daily for three weeks.

For diabetes, 20 milliliters of astragalus solution (equivalent to 40 grams of astragalus) in 250 milliliters of normal saline has been injected in the blood once daily for 30 days. Additionally, 4 grams of astragalus has been taken by mouth twice daily for eight weeks.

For fatigue (cancer), 500 milligrams of PG2 (extract) dissolved in 500 milliliters normal saline has been injected in the blood at a rate of 150-200 milliliters per hour three times weekly for eight weeks.

For heart disease or heart failure, 30-40 milliliters of astragalus (equivalent to 24-80 grams crude astragalus) has been injected into the blood daily for up to four weeks. Astragalus injections in the blood have ranged from 10-60 milliliters for 7-30 days. Additionally, 20 grams of astragalus has been taken by mouth three times daily. A dose of 2.25 grams of astragalus granules has been taken by mouth twice daily for two weeks.

For herpes of the eye, 0.5 milliliters of astragalus (1:1 extract) has been applied for three weeks.

For immune system stimulation, 20 milliliters of astragalus added to 250 milliliters of 5% glucose solution has been injected into the blood. Additionally, 10 milliliters of a preparation equal to 15 grams of astragalus has been injected into the blood twice daily for eight weeks.

For an infection, 2 milliliters of astragalus has been injected into two acupuncture points three times weekly for eight weeks.

For kidney failure, 20-40 milliliters of astragalus solution in 250 milliliters of 5% dextrose has been injected in the blood daily for up to a month. Additionally, 20-60 milliliters astragalus solution has been injected in the blood daily for 2-6 weeks.

For lupus, 20-40 milliliters of astragalus solution (equivalent to 40-80 milligrams of astragalus) in 250 milliliters of 5% dextrose, has been injected into the blood once daily for 12 consecutive days each month or for four weeks.

For stroke, 20 milliliters of astragalus solution (equivalent to 40 grams of astragalus) in 250 milliliters of 5% dextrose in water has been injected into the blood once daily for 10 days.

For tuberculosis, a dose of 20 milliliters has been injected into the blood daily for two months.

For viral myocarditis (inflamed heart), an injection equivalent to 8 grams of pure astragalus has been injected into the blood daily for 3-4 months.

For wound healing, a preparation of 10% astragalus ointment has been applied to wound surfaces.

Children (younger than 18 years)

General: Children have been given adult doses proportional to their body weight once daily for up to one month. There is not enough scientific data to recommend astragalus for children.

For the common cold or upper respiratory tract infection, 10 milliliters of astragalus solution has been taken by mouth twice daily if six years of age or younger, and three times by mouth daily if over six years of age.

For infection, children less than three years of age received 7.5 grams of astragalus (in astraglus granules) by mouth twice daily. Children 3-6 years old received 10 grams by mouth twice daily. Children over six years old received 15 grams by mouth twice daily, both alone and addition to standard steroid protocol. Duration of treatment was 3-6 months.

As an immune system stimulant, 15 milliliters of astragalus has been injected into the blood every 12 hours for seven days.

Safety
The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

Allergies

Avoid with known allergy or sensitivity to Astragalus membranaceus, its parts, or other members of the Fabaceae family. In theory, patients with allergies to members of the Leguminosae (pea) family may react to astragalus. Cross-reactivity with quillaja bark (soapbark) has been reported.

A positive skin reaction to astragalus powder injection has been reported.

Side Effects and Warnings

Astragalus is likely safe when taken in suggested doses.

Astragalus may increase the risk of bleeding. Caution is advised in people with bleeding disorders or taking drugs that may increase the risk of bleeding. Dosing adjustments may be necessary.

Astragalus may lower blood sugar levels. Caution is advised in people with diabetes or hypoglycemia, and in those taking drugs, herbs, or supplements that affect blood sugar. Blood glucose levels may need to be monitored by a qualified healthcare professional, including a pharmacist, and medication adjustments may be necessary.

Astragalus may alter blood pressure. Caution is advised in people taking drugs or herbs and supplements that alter blood pressure.

Use cautiously when injecting astragalus rapidly into the blood or taking high doses of astragalus for a long time.

Use cautiously in people with autoimmune disease, gastrointestinal conditions, high blood pressure, musculoskeletal disorders, neurological disorders, or skin conditions. Use cautiously in pregnant or lactating women.

Avoid with known allergy or sensitivity to Astragalus membranaceus, its parts, or other members of the Fabaceae family. Avoid in people with allergies to members of the Leguminosae (pea) family or quillaja bark (soapbark).

Note: In theory, consumption of the tragacanth (the gummy sap derived from astragalus) may reduce absorption of agents taken by mouth. Therefore, tragacanth and other agents should be taken at separate times.

Pregnancy and Breastfeeding

There is a lack of sufficient evidence to recommend astragalus during pregnancy and lactation. Studies of toxic astragalus species have reported harmful effects during animal pregnancies, leading to abortions or abnormal heart development.

Astragaloside IV, a component of astragalus, has demonstrated maternal toxicity and toxic effects in the fetus.

Astragalus may increase lactation. However, clinical evidence in support of this use is lacking.

Astragalus may lower blood sugar levels. Caution is advised when using medications that may also lower blood sugar. People taking drugs for diabetes by mouth or insulin should be monitored closely by a qualified healthcare professional, including a pharmacist. Medication adjustments may be necessary.

Astragalus may increase the risk of bleeding when taken with drugs that increase the risk of bleeding. Some examples include aspirin, anticoagulants ("blood thinners") such as warfarin (Coumadin®) or heparin, anti-platelet drugs such as clopidogrel (Plavix®), and non-steroidal anti-inflammatory drugs such as ibuprofen (Motrin®, Advil®) or naproxen (Naprosyn®, Aleve®).

Astragalus may alter blood pressure. Caution is advised in people taking drugs that alter blood pressure.

Because astragalus contains estrogen like chemicals, the effects of other agents believed to have estrogen-like properties may be altered.

Astragalus may lower blood sugar levels. Caution is advised when using herbs or supplements that may also lower blood sugar. Blood glucose levels may require monitoring, and doses may need adjustment.

Astragalus may increase the risk of bleeding when taken with herbs and supplements that are believed to increase the risk of bleeding. Multiple cases of bleeding have been reported with the use of Ginkgo biloba, and fewer cases with garlic and saw palmetto. Numerous other agents may theoretically increase the risk of bleeding, although this has not been proven in most cases.

Astragalus may alter blood pressure. Caution is advised in people taking herbs or supplements that may alter blood pressure.

Because astragalus contains estrogen like chemicals, the effects of other agents believed to have estrogen-like properties may be altered.

The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.